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Scoliosis is usually diagnosed by a combination of physical examination and X-ray. Scoliosis typically causes a side-to-side curve in the back with a variable amount of rotation in that side-to-side curve.
Curve rotation will cause secondary changes in the area of the body where the curve is located. The secondary changes can be any of the following: uneven shoulders, a rib hump/asymmetry, a low back hump/asymmetry, a change in the shape of the waist, or uneven pelvic bones or hips.
When a person bends forward at the waist with their arms hanging down in front of them, the previously mentioned changes are usually made much larger. The pronouncement of these changes is what your physician is looking for to help make the diagnosis of scoliosis.
Sometimes a curve is large enough that these changes can be visible in a person standing at rest but more frequently asymmetries are not noticed until the bend forward test is performed. It is not uncommon for very small curves to go unnoticed even with the bend forward test.
X-rays are important for not only seeing the shape and confirming the location of the curve, but also for measuring the size of the curve, so it can be classified. Many treatment decisions are influenced by the size and location of the scoliosis curvature, but other factors such as pain, imbalance, and additional underlying disease processes will also influence your physician’s treatment plan.
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